The following is an excerpt from an article I wrote for healthyplace.com on the difference between bipolar depression and uni polar depression. I wonder how well you can do! A lot of it was new to me as I wrote the article!
A Quiz: Name that Depression
The following examples will help you (or someone who cares about a person with depression) get really clear on the depression you experience. This can lead to the right treatment plan.
1. Have you ever been depressed and thought, “What is going on? I felt fantastic just last month! I had so much energy and life was great. I don’t understand this. Nothing happened? What’s wrong with me? Who am I?” and then you feel fine again a few months later. (BP Depression with rapid cycling between mania and depression.)
2. You went through a job loss and got depressed for the first time and then the depression went away when you got another job. (Situational Depression.)
3. You were depressed, took an antidepressant and then suddenly things got better. You felt your head clear and even your vision got razor sharp where colors were gorgeous and people looked beautiful. Life was full of hope and you couldn’t wait to make plans for the future. If someone said you seemed abnormally upbeat, you said, “I finally found a medication that worked and now you want me to go back to being depressed?” (Antidepressant induced mania.)
4. After a down mood for over a year you went through months of feeling great where you partied a lot, made friends easily, worked effortlessly and had a lot of ideas. The good mood raised a lot of confusion in your friends and family, but not enough to see it as an illness. You thought, “This is the real me! The depression is finally gone!” (A manic episode after a long BP Depression.)
4. Felt depressed and uncomfortable with agitation, trouble sleeping and the fear that someone was following you. Your thoughts were racing and your patience was low. You felt a lot of suspicion, heard voices and yet you had a lot of energy. You sometimes had suicidal thoughts. (Mixed episode with depression, mania and psychosis.)
6. People commented on your down mood and seemed confused as to why you were always depressed when you had so much to live for. You had trouble getting out of bed, had no enthusiasm for life, cried a lot and felt hopeless. Your work and relationships suffered. You had either been like this for months or had a low level depression for years. You found an antidepressant that worked and have not experienced depression again. (Unipolar depression)
7. You’re depressed and have tried five antidepressants. They don’t help at all and you feel more and more despondent. Your health care professional says, “I have no idea why these meds aren’t working. There is a drug called Lamictal that works with depression, let’s see if that will help.” You take the Lamictal and feel better. The doctor asks, “Have you ever had a mood where you were filled with energy and didn’t sleep much but were not tired at all the next day?” This question finally leads to a discussion about bipolar disorder and you both realize the medications didn’t work because you have BP Depression and have had mild mania for years without knowing what it was. Eventually the illness was stabilized with Lamictal and an antipsychotic. And you can truthfully say, “I finally feel like the real me.” (BP Depression)
What above situation describes you (or the person you care about)? Is treatment correct and adequate? The answer to these questions can help you take charge of your BP Depression so that you can get an official diagnosis, find the right combination of medications and create a treatment plan that is BP Depression specific. It may be scary, overwhelming and confusing to realize you have Bipolar Depression, but the diagnosis is a life saver. It makes sense to spend a few years finding the right treatment plan than experiencing a lifetime of depression. The results can lead to a stable life that is filled with great relationships, productive work, a true sense of purpose and joy.
Julie
This is an excerpt from my article on the difference between uni polar depression and bipolar depression published on healthyplace.com. The article is available in full on the menu to your right.
There’s not much worse than dysphoric mania. My doctor called it agitated depression (that’s before I was properly diagnosed B1) You have the energy, but there is so much agitation and negativity associated with the mood. I spent a week in the hospital with this, heard voices, saw figures, was an angry out of control patient. Meds helped, as did time in the hospital. A very unpleasant state of mind. Helen
Hi Helen, I agree. It’s like your body wants to turn inside out. It’s so uncomfortable. I am so glad you’re better. Meds really do help this kind of mania- often it’s a combination of a mood stabilizer and an anti psychotic.
Many people get in trouble when they’re in this mood swing as it makes a person so compulsive.
Julie
I agree with the description of number 6 (I was diagnosed with post-traumatic stress disorder, dysthymia, and major chronic recurrent depression when I was 18 and I am 24 now.) Maybe it is because I also have dysthymia, but I don’t think it is totally accurate to say that depression doesn’t return after finding the right medication or that it even completely goes away. I don’t think I am bipolar because it took me about 2 years to find the right antidepressant and I never felt like what you were describing in situation #3. The main reason I changed medications was because if the stimulant was too strong (like Effexor, an SNRI) it would make my PTSD worse and I would have panic attacks or uncontrollable 2+ hour crying spells more often and over much smaller things like just being late somewhere, or someone talking to me in a harsh tone of voice but not actually yelling.
I saw the same psychiatrist and counselor for 3 years and they both said every time they saw me, I was in the same mood and that I had a flat/depressed affect. My counselor saw me every week so I don’t think I had a manic or hypomanic period that she missed. I had to change counselors after graduating from college and the one I have now basically gave up on me. She criticized me because my mood has not improved and “I am so depressed all the time”. She hasn’t seen me since my Wellbutrin XL dose was changed from 150 to 300 mg. Now it is easier for me to recover from being triggered or stressed out and I can stop crying faster. I feel calmer overall but that is the only difference.
So anyway, I just wanted to let you know there might be an option that fits somewhere between 6 and 7. My psychiatrist and counselor told me since when I was younger I wasn’t allowed to get help, the depression has become a permanent part of my personality. The brain changes from my depression and PTSD can’t go away now that I’m an adult.
I’m with Helen. When stuck at the low end of my bipolar experience, at least my mood is consistent and I can just hunker down and sleep a lot to escape it. But dysphoric mania is absolute hell. Lots of energy, but it’s all directed into anger, paranoia, and useless activity.
For me, the worst part of being Bipolar is the inability to be productive. I’m about to lose my house and am fully cognizant of how to save the situation. I know I have the ability and the skill to put things right. But this insidious illness takes away the necessary focus to act on what my mind knows to be the proper course of action. For those without Bipolar disorder, please try to understand this aspect of it. Imagine yourself with a crystal clear idea of how to fix something or being able to clearly see a path before you. Now, imagine you also have the intelligence and experience to navigate those waters. Now, imagine the frustration you’d feel being completely unable to focus on a task long enough to see it through. Even the simplest tasks.
Finally, imagine that nothing you try fixes it (medication, talk therapy, will power, etc.)… and imagine not just years of living with this reality, but decades… a lifetime.
That’s our world.
I’m new to Julie’s articles and am gobbling them up as fast as I can. So much on these topics is written by people that do not have the depth of experience necessary to speak with any authority. Julie clearly does.
Her articles have led me to conclude that I’ve been mis-diagnosed with unipolar depression and actually suffer bipoloar-II. About ‘half my puzzle’ is depression, and the other half is a mix of anger, anxiety, mania, irritability, and so on. I never knew what to make of any of the non-depression stuff. I never considered it part of my central problem. I just thought that when not depressed, life simply sucked in a more energetic way.
Great comments on this post. Amazing how intelligent and well spoken people with these diseases can be.
Thank you Julie for giving me hope.
I get depression because my sister Brandy pass way on July 7,2001. I get angry and upset and start to yell at my fiance. I cry about my sister brandy every night and i have dream about her too. I don’t want to be depression anymore. I don’t want to do about my depression. Please help me.
Thank you,
Racheal Clark
Hi Racheal,
I usually have an answer to questions on this blog on how a person can best manage bipolar disorder and how family members can help- for you I have different advice.
I suggest a grief counselor/therapist. Therapists are listeners and can understand what you’re going through. It’s essential that you find one who deals with the loss of someone you love. The death of your sister can be a constant trigger of your depression. When you get help for your grief, I think the depression will get better.
Good luck to you, Julie
hi my name is tricia i am 18 years old and i am suffering from bipolar depression, i havnt seeked help and my mood swing are becoming worse.” so far i dropped out of high school because of stress and emotional mood swings that took over and forced me to quite on school, i couldnt concentrate at all, i cried everynight from being so down on my self and my life, i act out in ways that get me in trouble and i feel alone and lost, suicidal thoughts often occure almost daily and this has all lead me to where i overly sleep, lose interest in everything, cut my self, yell and get in fights and i cant control how im feeling or focus on work. i am scared that one day i will kill myself and hurt the ones that love me the most. ive been this way for years and never seeked special treatment because of my busy scheduale. please write back thank you.
Hi, I’m 16 and I have been dealing with depression for about 3 years now. I get pretty much the whole package, suicidal thoughts, cutting, extreme anxiety ect. I can feel so so good at one moment and then feel like killing myself just minutes later. I also get these moments when I feel so out of my body, I hate it all. I’ve been doing some research about my symptoms but I was wondering if I could have your opinion. Thank you.
-Ali
Hello Helen, I am a 71 year old male who is going through the most traumatic period of my life I have ever experienced and it’s absolute hell. I lost my wife of 52 years very suddenly almost 2 years ago. Days after her funeral I got news (after prolonged tests and some hospitalization)that I had stomach cancer. I had major surgery 12 months ago with success and am currently on adjuvant daily chemotherapy.I know I have suffered from depressive bouts all my life, and particularly SAD. Before my wife died, I was more or less stabilized on antidepressants (mainly paroxetine which I took for years)but lead a pretty normal life with just occasional depressive swings.But since her death I have had the most awful roller coaster existence, when for perhaps a few weeks I felt fine, got on with life but perhaps more self centered and neglecting my family and friends socially.Then I would overnight plunge into a pit of despair, anxiety, quite unable to mentally or physically function properly even though I knew what things I had to do.Not caring, if you like. Struggle to get up, try and hide away from dull sunless days etc.
As I write, I have been in the ‘bad’ place again for the last 10 days or so.But what prompted me to write, after reading your article, was that yesterday I began the day on a relative ‘high’, but became more aware as the day went on that I was slipping back again. This hasn’t happened before. It has usually been ‘up’ for a few weeks then ‘down’again, I’ve lost count of the episodes. I have been referred for counseling (CBT, Talk Therapy etc) over a number of weeks relatively recently, but nothing seems to help. I currently take Pregablin 75mg twice daily for anxiety (so I’m told) and Setraline 50mg once daily. Antidepressants throw up there own problems inasmuch as whatever I am prescribed has to be cleared with Oncology on account of chemo contraindications (Imatinib)so that I am stuck on the current dose of Setraline because of this, and cannot have Paroxetine at all. Then in a copy of a letter received today from Oncology to my GP the word ‘lithium’ popped up in their discussions. Looking it up, I see it seems to be used to treat bipolar disorder.Sorry it has taken so long, but do you have an opinion based on these notes?